Part of the debate – in the Senedd at 5:36 pm on 17 January 2018.
Thank you very much, Presiding Officer. I'd like to thank everyone who has participated in the debate and again echo our thanks to the clerks and researchers for all of their work, and of course to those who have provided us with evidence over the past months. It was wonderful to meet with many of them, as Julie Morgan said, at lunchtime at the Pierhead in order to complete the circle, as it were. They'd presented evidence, they'd read our report, they'd seen the Government's response to it, and then they could discuss that. That's the first time that we as a committee have done that, and I would see it as a template for other committees, as a modus operandi for them too.
There were a number of speakers: Angela, Rhun, Dawn, Julie, Caroline, Jenny. I was pleased to have a contributor who is not a committee member—not that I want to disrespect any committee member who spoke, but it was nice to have a non-committee member contributing to the debate, and, of course, we also heard from the Cabinet Secretary himself.
The fundamental point—and we will continue to disagree on this point, I'm sure—is this need for financial security to employ, in particular to employ new staff at cluster level. The Cabinet Secretary himself mentioned those examples of clusters employing paramedics, and also pharmacists. It's far easier to employ someone on a three-year contract than a one-year contract. That's the fundamental point that many of our witnesses made, that they need that financial security, and also contractual and pension security, in terms of who manages those. Because the clusters themselves are an entity that, unlike the health boards, are not a legal entity in terms of employment issues. So, those are the issues that need to be resolved in order to get those paramedics and pharmacists, who do laudable work, I have to say, because the paramedics we have in the cluster that I am part of have transformed the way we work. If there's an emergency call now in the middle of a surgery, a GP doesn't have to leave the surgery, and all the patients there, to go and see someone who may have fallen or whatever. The paramedic is there and they phone us. It has transformed the way in which we run our services from day to day. Therefore, they do make a valuable contribution, and we need to retain them and respect them.
So, we've heard all of the arguments made, and I won't rehearse the arguments as to which recommendations have been accepted and which have been rejected, but it is true to note that these clusters are an exciting development. I'm old enough to have had the very debate that the Cabinet Secretary mentioned—at the start, years ago, no-one was sure whether these were going to work or whether they would be an additional layer of bureaucracy for GPs, with not enough of us in place in the first place, and more work would need to be done and so on. Well, we've partially overcome that problem, but partially the jury is still out. That's why people are asking, and that's why the main recommendation of this report is that we need a fundamental change, a step change indeed, in terms of the development of the clusters and their implementation, so that we can secure and achieve this aspiration of having these MDTs working together for the benefit of our patients. Thank you very much.